Nearly one-third of cancer survivors and their partners reported job lock — having to remain at a job because of concerns about losing health insurance, according to a cross-sectional study reported in JAMA Oncology.

“Given that most health insurance coverage for working-age individuals in the US is employer-based, a challenge is the inability to freely leave a job given limitations on health insurance portability,” the authors wrote.

Because job lock affects career trajectory and quality of life, the authors conducted the study to determine the prevalence of job lock among cancer survivors and their spouses/partners.

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The study analyzed data from 1340 cancer survivors and 1593 partners of cancer survivors who answered job lock-related questions in the 2011, 2016, and 2017 Medical Expenditure Panel Survey Experiences With Cancer questionnaire. The data did not capture cancer stage or type of treatment.

Among cancer survivors, 19.6% (95% CI, 17.1%-22.3%) reported job lock. Job lock was significantly associated with younger age (P <.001) and income between 138% and 400% of the federal poverty level (FPL; P =.003).

Partners of cancer survivors reported job lock in 10.7% (95% CI, 8.4%-11.9%) of cases. Female sex (P =.03), younger age (P <.001), being married (P =.02), nonwhite ethnicity (P <.001), and income level between 138% and 400% of FPL (P <.001) were significantly associated with job lock.

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“It is important to note that those earning between 138% and 400% of the FPL are ineligible for Medicaid and may have fewer employment opportunities with comprehensive health benefits,” the authors wrote.

The authors concluded that “clinicians, social workers, and navigators have opportunities to identify job lock and other employment concerns throughout treatment/survivorship care and connect survivors with employment and health insurance counseling.”


Kent EE, de Moor JS, Zhao J, et al. Staying at one’s job to maintain employer-based health insurance among cancer survivors and their spouses/partners [published online April 23, 2020]. JAMA Oncol. doi: 10.1001/jamaoncol.2020.0742